Pathophysiology of Diabetes Mellitus
Respond on two different days who selected different factors than you, in one or more of the following ways:
Share insights on how the factor you selected impacts the pathophysiology of diabetes mellitus and diabetes insipidus.
Offer alternative diagnoses and prescription of treatment options for diabetes mellitus and diabetes insipidus.
Validate an idea with your own experience and additional research.
Main post
Diabetes affects millions of Americans and the cost of diabetes is a constant healthcare stressor as Insulin costs continue to rise. Diabetes mellitus is separated into three classes; Type 1, the pancreas fails to produce enough insulin to meet the body’s demand and Type 2, where the body’s cells do not respond to the insulin production and can be managed with lifestyle modifications, and gestational diabetes. Diabetes insipidus is not as common as diabetes mellitus but can have a severe effect on the human body due to the fluid imbalance that is created. It is important for the practitioner to understand the pathophysiologies and the roles behavior and ethnicity play in the diagnosis and treatment.
Pathophysiology of Diabetes Mellitus
Type 1 diabetes mellitus is an autoimmune disease that results from beta-cell destruction in pancreatic islets. Beta-cell death via virus directed or physiological mechanisms induces the release of antigens and initiation of immune responses against other beta-cells (Saberzadeh-Ardestani et al., 2018). Type 2 diabetes also has beta-cell destruction more but, more variable different degrees of beta-cell failure relative to varying degrees of insulin resistance. Kumar et al. (2018) acknowledge that insulin resistance impairs the ability of muscle cells to take up and store glucose and triglycerides, which results in high levels of glucose and triglycerides circulating in the blood. Type 2 diabetes can be managed with diet and exercise; like these, both can improve insulin resistance and delay the long-term complications associated with diabetes mellitus.
Pathophysiology of Diabetes Insipidus
Diabetes insipidus is separated into four classifications; central, nephrogenic, dipsogenic, and gestational. The results are that the body excretes an abundance of urine, causing the patient to have an unquenchable thirst. Kalra et al. (2016) describe central diabetes insipidus due to impaired secretion of arginine vasopressin could result from traumatic brain injury, surgery, or tumors whereas nephrogenic diabetes insipidus due to failure of the kidney to respond to arginine vasopressin is usually inherited.
Differences and Similarities of Hormonal Regulation
Despite sharing a name, the differences between diabetes mellitus and diabetes insipidus are great, from the pathophysiology to the treatment. Similarities between diabetes insipidus and diabetes mellitus due to hormonal changes lie within the symptoms that the patient is experiencing. Diabetes mellitus involves blood sugar levels and insulin resistance; diabetes insipidus, it isn’t blood sugar that is the problem, but blood water levels. The similarities of these diseases lie within the signs and symptoms that the patients may be present. Diabetes insipidus, excessive fatigue occurs because of an overall lack of hydration or an electrolyte imbalance. For diabetes mellitus, excessive fatigue generally occurs because blood sugar levels are too low or too high. Excessive thirst occurs in diabetes insipidus because the body senses a lack of Vasopressin, and so it demands more fluids because it thinks it needs them. For diabetes mellitus, excessive thirst occurs because of excessive glucose levels that need to be expelled from the body.
Ethnicity and Behavior’s Impact
Research by Saberzadeh-Ardestani et al. (2018) shows environmental factors include reduction in gut microbiota, obesity, early introduction to fruit or cow milk during childhood, gluten, toxins, lack of vitamins, and viruses play a role in the development of diabetes mellitus type 1; while previously most prevalent in Europeans, it is becoming more common in other ethnic groups. Diet and exercise can help delay diabetes mellitus type 2 from other disease processes related to diabetes mellitus. Diabetes insipidus is common when a traumatic brain injury (TBI) occurs, wearing seatbelts when driving and helmets when participating in cycling or sporting events can decrease the opportunity for diabetes insipidus to occur.
Conclusion
It is important for a practitioner to distinguish between the multiple types of diabetes that patients may present with, although signs and symptoms may be similar, the diagnosis and treatments are completely different. Patient education for each disease is also important because diabetes mellitus type 1 cannot be managed with diet and exercise alone. Diabetes insipidus can occur, but the underlying cause must be singled out to classify and treat. Central diabetes insipidus may require long term treatment depending on the extent of trauma, whereas gestational diabetes insipidus is usually a short term treatment, but the treatments remain the same.
References
Kalra, S., Zargar, A. H., Jain, S. M., Sethi, B., Chowdhury, S., Singh, A. K., … Malve, H. (2016). Diabetes insipidus: The other diabetes. Indian Journal of Endocrinology & Metabolism, 20(1), 9–21. https://doi-org.ezp.waldenulibrary.org/10.4103/2230-8210.172273Kumar, A. S., Maiya, A. G., Shastry, B. A., Vaishali, K., Ravishankar, N., Hazari, A., … & Jadhav, R. (2018). Exercise and insulin resistance in type 2 diabetes mellitus: A systematic review and meta-analysis. Annals of physical and rehabilitation medicine. https://doi-org.ezp.waldenulibrary.org/10.1016/j.rehab.2018.11.001Saberzadeh-Ardestani, B., Karamzadeh, R., Basiri, M., Hajizadeh-Saffar, E., Farhadi, A., Shapiro, A. M. J., … Baharvand, H. (2018). Type 1 Diabetes Mellitus: Cellular and Molecular Pathophysiology at A Glance. Cell Journal (Yakhteh), 20(3), 294–301. https://doi-org.ezp.waldenulibrary.org/10.22074/cellj.2018.5513
